Abstract

There is considerable debate in the literature on the appropriate preoperative treatment of esophageal squamous cell carcinoma (ESCC), with valid options being chemotherapy (CT), chemoradiotherapy (CRT), followed or not by surgery. Some authors are of the opinion that in patients with good clinical response, surgery can improve local control and minimize, in case of relapse, the need for palliative stenting; however, surgery does not seem to improve overall survival. Late surgical morbidity and mortality, even in high-volume centers, is still considerable. For this reason, definitive CRT has been proposed for patients with advanced ESCC (cT3-cT4), restricting surgery to non-responding patients (salvage surgery) [1, 2, 3, 4, 5].